title: Impact of young age on the prognosis for oral cancer: a population-based study in Taiwan.
abstract: BACKGROUND
  Oral cancer leads to a considerable use of health care resources. Wide resection of the tumor and reconstruction with a pedicle flap/ free flap is widely used. This study was conducted to investigate if young age at the time of diagnosis of oral cancer requiring this treatment confers a worse prognosis.
  
  
  METHODS
  A total of 2339 patients who underwent resections for oral cancer from 2004 to 2005 were identified from The Taiwan National Health Insurance Research Database. Survival analysis, Cox proportional regression model, propensity scores, and sensitivity test were used to evaluate the association between 5-year survival rates and age.
  
  
  RESULTS
  In the Cox proportional regression model, the older age group (>65 years) had the worst survival rate (hazard ratio [HR], 1.80; 95% confidence interval [CI], 1.45-2.22; P<0.001). When analyzed using the propensity scores, the adjusted 5-year survival rates were also poorer for oral cancer patients with older age (>65 years), compared to those with younger age (<45 years) (P<0.001). In sensitivity test, the adjusted hazard ratio remained no statistically elevated in the younger age group (<45 years).
  
  
  CONCLUSIONS
  For those oral cancer patients who underwent wide excision and reconstruction, young age did not confer a worse prognosis using a Cox proportional regression model, propensity scores or sensitivity test. Young oral cancer patients may be treated using general guidelines and do not require more aggressive treatment.
authors.affiliation: Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Ting-Shou
authors.initials: TS
authors.lastname: Chang
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Hsu-Chieh
authors.initials: HC
authors.lastname: Ho
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Su
authors.forename: Li-Fu
authors.initials: LF
authors.lastname: Chen
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
authors.forename: Ching-Chih
authors.initials: CC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000503:physiopathology* / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology